Tạp chí của Hội Y tế Công cộng Việt Nam
Vietnam fertility trend and determinants after a decade at the replacement level: an implication for the recent rebound in developed regions
Vietnam has more than 5 decades of fertility control policy and now authorities are looking for a change after a decade of plateau fertility at the replacement level. They raised questions about fertility determinants which could help predict the total fertility course in coming years. There were 5 intermediate determinants selected and brought into analysis in a period of 10-15 years. Meaningful visual graphs were employed to identify patterns and changes between determinants and total or age group fertilities overtime. From the data of 63 provinces, in the last decade, there were 2 opposite trends to keep the country wide fertility in balance: declining one in less developed areas, and uprising one in low land developed regions. While the former was a result of development and its components like poverty reduction, education for girls, gender equity and public health, the later was the consequence of migration process more obviously in industrialized provinces. Vietnam is still facing possible rising fertility unless the family planning services and jobs are available for young couples. In this point of view, there is a need for immediate and effective family planning and job creation policies for the youth in both less and developed regions. The ﬁ ndings not only supported but also applied Adaptation theory to explain the rebound of fertility in developed regions. At a larger picture, the recent rebound of fertility in developed countries which experienced a long, continuous ﬂ ows of migrants could be part of migration process and continue evolving.
Sexual harassment - a hurdle to female promotion
The existence of sexual harassment in the workplace is one of main hurdles to hinder women’s advancement to the top positions of media companies in Vietnam. Female journalists are commonly believed that they are aggressive enough not to be sexually abused by men. Yet some of middle-aged female executives of Voice of Vietnam, one of the two largest state-owned broadcasting organizations disclosed being harassed, based on 12 in-depth interviews in 2015 and 2016. Their working environment is tolerant with sexual harassment when sensitive jokes related to female body parts and sex are perceived as normal and funny, and unwanted touching is acceptable. Victims thus normally keep silence and harassers are not punished. This long-decade tolerance is reinforced by four interconnected contexts, namely individual, cultural, social and institutional circumstances. This fact poses a major impediment for women to be promoted when they feel stuck in the dilemma. If they publicly blame abusers at ofﬁ ce, they can be perceived as an unfriendly colleague, which may lose potential votes for their promotion. In the contrary, they can be labeled to get advancement because of accepting unexpected abusiveness.
Impact of extra-curricular activities on reproductive health knowledge of high school students in Lao Cai province, Viet Nam
The study was conducted on 466 students at No.1 high school and at Bao Thang high school in Lao Cai province to assess the effectiveness of extracurricular activities in improving knowledge of reproductive health. The students were divided into two groups: A control group who did not participate in the extra-curricular activities on reproductive health, and an experimental group who did participate in extra-curricular activities on reproductive health. The results showed that students in the control group knew relatively little about reproductive health (approximately 30% and 90% of students who did not know about important puberty signs and conceiving time during menstrual cycle, respectively) while those in the experimental group improved their knowledge of reproductive health markedly. The results also suggest that besides the integration of reproductive health contents with other subjects, providing extra-curricular activities is useful to increase high school student’s knowledge of reproductive health.
Different information sources students access for safe sex information and attitudes toward sexuality of Ha Noi high school students
The aim of this study is to explore high school students’ attitudes toward sexual intercourse at high school ages and to identify the different information sources which students had accessed for information and knowledge regarding safe sex. With the sample size of more than 1330 respondents, the results showed that on average each students had accessed 3.4 out of 6 different information sources that provided information on this topic. The proportions of students who had received/achieved safe sex information from indirect sources such as internet, social networks, mass media was higher than from direct sources: their parents, teachers and their friends. The percentage of male students reporting sexual intercourse was higher than female students and at the same time, they were also the respondents who had received safe sex information from direct sources at very low rate in comparison to female students. The results have implications for improving the schools’ and parents’ roles and their responsibilities in educating and communicating with high school students on reproductive health and safe sex.
Gaps between the situation and the needs of receiving information about reproductive health among adolescents at a high school of rural area in the north of Viet Nam
Introduction: Adolescents today have access to several sources of information about reproductive health and so they should have good knowledge and good practices about safe sex. But in fact, many studies have shown that knowledge and the practice safe sex by adolescents was as not good as expected. Therefore, it is important to explore the sources and needs for information about reproductive health to improve information levels is essential. Methods: This is a cross sectional study at the High School Number 2, Hiep Hoa District, Bac Giang Province in 2015 usingcombined qualitative and quantitative research methods. A total of 642 students from 3 grades were included in the study and from them, 42 students were randomly selected to join in depth interviews and focus group discussions. Results: About 54% of students had received information about reproductive health, but 33% did not consider the information was enough or did not meet their needs (13.4%). Among students, 77.0% of them wanted to be provided knowledge on this issue, especially through outdoor activities at the school (50.6%). The forms that they liked to be provided knowledge including sharing with experts, playing games and consulting directly. The form they liked most was sharing with experts about issues of reproductive health which they pay attention (63.3%). Conclusions: The information about reproductive health that students received did not meet their needs. Students had some difﬁ culties when receiving or ﬁ nding information about reproductive health. However, they still had a high demand of being informed about certain contents of reproductive health that they thought useful at school
Rights based-approach understanding of sexual and reproductive health and rights among adolescents in Thua Thien Hue province, vietnam
Introduction: After more than twenty years of exploring and promoting globally Sexual and Reproductive Health and Rights (SRHR), the majority of Vietnam adolescents are still not able to claim their rights. The study evaluates youth’s knowledge, attitude, and demand; and determine the factors which inﬂ uence the current knowledge, attitude of adolescents about SRHR. Methods: This is a cross-sectional study using a mixed method approach. For quantitative research, 3080 students (aged 1118 years) ﬁ lled in a self-administered structured questionnaire. A two-stage sampling method was performed, based on the student proportion of high schools in Thua Thien Hue Province, Vietnam. For qualitative research, focus group discussions were conducted with four distinct groups of students and six personal interviews were held with teachers and local authorities. Result: The research revealed that 68.8% of students wanted access to servicesbut only 32.2% of the students actually knew about SRHR. The knowledge of students about SRHR was associated with age of the students and the education level of their respective mothers. The attitude of students to SRHR was related to the age and gender of the students; the marital status of their parents and the education level of mothers. Conclusion: As a fundamental human right, the improvement in the awareness and capacity of adolescents on SRHR plays a vital role in the promotion of sexual and reproductive comprehensive healthcare systems accessibility towards young people.
Two years ago, the world leaders adopted the 2030 Agenda for Sustainable Development at the United Nations S ustainable Development Summit. The achieving gender equality and empower all women and girls became one of the goals (Goal 5) among 17 Sustainable Development Goals (SDGs) to end poverty, ﬁ ght inequality and injustice, and tackle climate change by 2030.
Liver fluke infection in vietnam: A review
Introduction: Zoonotic trematode infections are an area of the neglected tropical diseases that have become of major interest to public health, including liver ﬂ uke disease caused by Clonorchis, Opisthorchis, Fasciola and Paragonimus. Vietnam is in hot and humid tropics with a high rainfall. These are favorable conditions for the development of intestinal worms, including the liver ﬂ uke. The liver ﬂ uke is widely distributed throughout the country with different prevalence in each region. Objectives: To summarize existing evidence on liver ﬂ uke and foodborne zoonotic trematode infection, and to highlight the local characteristics of liver ﬂ uke infections, including information on biological features, epidemiology, pathology and policies, and thus giving an appropriate insight into prevention and control of the diseases of liver ﬂ uke and foodborne zoonotic trematodes in Vietnam. Methods: A systematic literature search was conducted using the PubMed and ScienceDirect databases and data sources of National Institute of Malariology Parasitology and Entomology (NIMPE) in July 2016. The collected documents were summarized and categorized according to each research topic, related to liver ﬂ uke in Vietnam. Results: Totally, 31 references were included in this review (biological characteristics: 4; epidemiological characteristics: 8; Risk factors: 8; Health impacts of liver ﬂ uke: 7; Prevention and treatment: 4). Most of the studies focused on epidemiological characteristics and risk factors of liver ﬂ uke infection. Conclusion: In Vietnam, the number of liver ﬂ uke studies and its effects on human health are still limited. Therefore, It’s necessary to conduct further studies on a large scale in the community to ﬁ nd out the causes, risk factors, high-risk areas, the disease caused by the liver ﬂ uke and the long-term prevention solutions.
Exposure assessment of salmonella related to pork handling and consumption at households in Hung Yen and Nghe An provinces
Introduction: Along with poultry and eggs, pork meat represents one of the most signiﬁ cant risks of Salmonellosis. Pork accounts for 56% of the meat consumed daily in Vietnamese households and pork preparation and handling poses a major risk due to possible cross-contamination. The objective of this study is to conduct the exposure assessment by determination of Salmonella prevalence, concentration in market purchased pork and pork handling, and consumption at households in term of food safety in Hung Yen and Nghe An provinces. Methods: A total of 217 pork samples were collected from pork shops in wet markets for Salmonella analysis between April 2014 and February 2015. A cross-sectional survey on pork handling and consumption at households was also conducted using a structured questionnaire in 416 households in these two provinces. Results: Overall Salmonella prevalence in market pork was 44.7% with an average concentration of 9 (<0.3 to >110) MPN/g. Most of consumers purchased pork at the market in the morning around 7:30 am with an average purchase amount of 0.45 (0.1-9.5) kg pork/ time. The methods used for storing raw pork before cooking were at room temperature (54.6%, 228/416) or in a refrigerator (41.8%, 174/416)) with an average duration of 0.6 and 2.4 hours, respectively. The percentages of household using the same knife or cutting board to prepare both raw and cooked pork were 80.5% and 74.5%, respectively. Conclusion: These ﬁ ndings highlight the high level of Salmonella in pork sold at informal retail markets. This study also shows that the behavior and practices of Vietnamese consumers can present a risk of Salmonella cross-contamination in the household that required the training and education programs on food safety practice of consumer.
Knowledge and practice of farmers in using livestock waste in Ha Nam province for biogas generation in 2015
The objective of the study was to assess farmer’s knowledge and practices in the use of biogas generation to treat livestock waste. We conducted a study of 442 farmers who have biogas plants in their households in Hoang Tay and Chuyen Ngoai commune, Kim Bang Hanam province in 2015. The study results show that farmer’s knowledge and practices of using biogas was limited. In particular, properly knowledge of farmers about biogas operation, and safety of using biogas were 1.0 – 33.1%, and 16.4 – 72.9%, respectively. Proper practice of the farmers about observation of waste input loading, and observation of output biogas wastewater were 6.8 - 35.6%, and 20.1 - 36.3%, respectively. Our ﬁ ndings suggested that appropriate education and communication programs are needed to improve the knowledge and practices of farmers of biogas operation at household level.
Survey on some risk factors leading to avian influenza outbreaks in the period 2011-2015 and assessment of the immunication after the prevention of poultry raised in Binh Dinh province
This study was carried out on poultry raised in An Nhon Town, Tay Son and Hoai Nhon Districts, Binh Dinh Province. Through epidemiological investigation, results of evaluating risk factors that could lead to avian inﬂ uenzaoutbreaks in the province of Binh Dinh were sorted from high to low as follows: First, poultry were not vaccinated against avian inﬂ uenza; Second, disinfectant chemicals were not used; Third, poultry were not caged; and fourth, leftovers were used as food for poultry. Results of evaluating the immune response after vaccination for poultry showed that both breeding methods, caged breeding and backyard breeding, have reached the same rate of protection after vaccination, that was 88.3% (159/180 samples). For duck, rate of protected serum samples after vaccination reached 89.4% (162/180). Whereas, the un-vaccinated poultry of control experiment had natural protection rate of 4.4% (4/90 samples). Protection percentage of poultry after vaccinating with N AVET-VIFLUVAC NIBRG-14 was 89.6%, higher than with vaccine H5N1Re-6, which was 87.4% (P> 0.05).
Sanitary condition of slaughter houses and poultry slaughterers' knowledge and practice in Thai Binh province in 2015
Introduction: Poultry slaughterhouses in Thaibinh City still use manual practices and therefore, the risk of infectious disease from poultry to humans remains high. Methods: This is a cross-sectional epidemiological study conducted among 105 slaughterhouses and 226 poultry butchers. The aim was to describe sanitation in poultry slaughterhouses and examine knowledge and understanding of correct practices for f e the prevention of disease transmission from poultry to humans. Results. The slaughtering process is manual and on a small scale. There was no proper wastewater treatment found in most of slaughterhouses.; The majority (91.2%) of slaughtermen had understood how to prevent diseases transmitted from poultry to humans and approximately 60% of butchers used protective clothing. There is a need to improve the standard of slaughter houses in Vietnam and the standards of food safety and veterinary hygiene and it is recommended that educational programs for butchers should be widely promoted along with the development of slaughtering-focused areas based on the standards of food safety and veterimary hygiene.
Evaluation of a broadly-based control model of fascioliasis (liver fluke) in central Vietnam
Fascioliasis (liver fluke) has raised significant public health concerns in the 15 regional provinces of Central Vietnam. However, comprehensive strategies for fascioliasis control are not in place with reliance on chemotherapy as the main control measure. This study implemented a broadly-based control model comprising of five main components: vector control, health education, improvement of local health systems, involvement of concerned bodies, and chemotherapy. Following the intervention, significant reductions in seroprevalence (4.2% vs. 8.8%, p<0.05) was found in the Intervention 1 commune (broadly-based model), but not in the Intervention 2 commune (model comprising of human chemotherapy and animal chemoprevention) or the Control commune (Control commune, human chemotherapy only). Improvements in knowledge and practice of fascioliasis control were found in the intervention communes 1 and 2, although there remained significant differences in the levels of awareness in these two cohorts (80.2% vs. 37.5% respectively, p <0.017). Considerable changes in practices were found in the Intervention 1 commune with all poor practice items reduced significantly in comparison with the baseline level (p<0.017). Findings in this study also supported the effectiveness of the recommended chemotherapy (triclabendazole 250mg, 10mg/kg body weight) for selective treatment of fascioliasis. Having established the effectiveness of the broadly-based control model, it is important to explore the factors that enable, or act to impede, the implementation of a broadly based control model.
Costs - benefits of Vietnam family planning program for the period 2008-2013: An application of IMPACT-2
The costs and benefits of Vietnam Population and Family planning program for 2008-2013 period applied IMPACT-2 methodology to calculate health benefits and cost effectiveness. On average, annually in Vietnam there were 2.6 million pregnancies, 1.55 million live births, and 480 thousand abortions. Each year, the family planning program provided and delivered services for 11.2 million couples, of which 4.7 million women were new users. On calculation, the contraceptive use averted 4.3 million pregnancies probably leading estimatedly to 2.8 million live births, 897 thousand abortions and 1,600 maternal deaths. The aversion of women’s morbidity and disability burden was 103 thousand DALYs, equivalent to 1/2 the burden of women’s diabetes, 3/4 of tuberculosis. In general, Vietnam spent on average 570 billion VND on family planning services each year, which in return, saved 1,200 billion VND from maternal and child healthcare budget.
Determinants of home, commune health centre and hospital setting for vaginal birth in Vietnamese women
Introduction: Few quantitative studies globally have evaluated determinants for home, health centre and hospital birth separately, despite large differences between the services provided. This study explores the sociodemographic and pregnancy-related determinants of birth-setting in Vietnam (n=1812) for vaginal birth using Young Lives data. Methods: Random sampling obtained 2,000 children (age 6-18months) within four purposively selected regions: Northern Uplands, Red River Delta, Central Coast and Mekong Delta. Multinomial regression modelling explored determinants of use across birth setting: home (reference), health centre and hospital. Results: Women in the study reported hospital delivery (n=813, 45%), followed by health centre (n=563, 31%) and home (n=436, 24%). Women delivering at home were predominately from rural areas (98%), among the poorest women (73%), had no antenatal care (53%) and were multipara (64%). Women who lived in a rural area had lower odds (OR=0.29; 95% CIs 0.13-0.66) of health centre delivery, compared to their urban counterparts, however this was not the case for hospital delivery. Lower wealth decreased the likelihood of hospital delivery (OR=0.46; 95% CI 0.28–0.74), compared to home birth but had no significant effect on health centre delivery. Conclusion: This study found that sociodemographic and pregnancy-related determinants for home birth, health centre and hospital delivery were different for a number of factors in this population, having important implications for policy development.
Social support and depressive symptoms among elderly veterans in Vietnam: a cross-sectional study
In Vietnam, elderly veterans are prone to suffer depressive symptoms from their traumatic experiences. Social support is recognized as a stress buffer. Therefore, we aimed to identify the associations between social support and depressive symptoms among veterans ages 65 and older in Vietnam. A cross-sectional study was conducted from June to August 2010. We contacted male veterans age 65 and older and recruited 828 participants. They responded to a structured questionnaire completed as an in-person interview conducted by a researcher. Indicators of depressive symptoms and social support were validated in previous studies. Multiple linear regression analyses were used to identify the associations between social support and their depressive symptoms as well as to identify the influential sources of social support among family, friends and significant others. The mean (SD) score of depressive symptoms among elderly veterans was 15.4 (9.2). A significant association was detected between social support and depressive symptoms among the participants (p<0.01). Those who perceived higher levels of social support were less likely to have depressive symptoms. Regarding the sources of social support like family, friends and significant others, support from family (p < 0.01) and support from friends (p < 0.01) were significantly associated with depressive symptoms. However, support from significant others was not significant. Social supports from family members and friends are important factors against depressive symptoms among elderly veterans in Vietnam.
Traditional medicine: More effective services in rural areas
Rural areas in Vietnam encompass 9,068 communes, which are the lowest territorial and administrative units in the country where 60.7 million people (67.67% of total population) reside1-3. Despite a remarkable development in the past decades, these areas are still economically and socially disadvantaged. A rural inhabitant’s income per capita GDP is low: 1,124 USD/year, i.e. about half of the nationwide 2,109 USD/year and far less than that of the urban one4. Moreover, poor and ethnic minorities live mostly in rural areas. While the poverty rate for households nationwide is 4.5-5%, the poverty rate in rural areas is about 8.2%5. Vietnam’s health system is organized into central, provincial, district and commune levels. Almost all hospitals and clinics belong to the first three levels and are located in cities or towns. The nearest commune district hospitals are usually small and the number of their beds account for only 36% of total hospital beds. At the commune level, health stations (CHSs) are only state-owned health facilities. The ratios of medical doctors, nurses and midwives per 10,000 inhabitants in rural areas are apparently very low at 1.3, 2.3 and 1.9, respectively. Whereas those numbers in urban areas are much higher at 17.5, 25.5 and 5.56. Such distributions of medical facilities and staff are evidently unfavorable for rural dwellers whose opportunities to access to full and qualified health services are very limited, namely because: (i) The hospitals are located tens to hundreds of kilometers far away from their homes and are often overcrowded. The CHS’s capacitis are very limited due to lack of medical equipment and highly qualified medical workers (only 76% of CHSs have doctors). Therefore, these CHSs can provide only preliminary and simple medical services as first aid, temporary or emergency treatment for simple cases and midwife services. In cases beyond capacity, patients are subject to being transferred to the district or higher level hospitals. (ii) Due to financial constraints, most rural inhabitants find it burdensome to go to these hospitals, as the transportation and communication infrastructure is still poor. These issues are one of the main reasons of inequity between rural and urban people in accessing quality health services7,8.
Factors Influencing Unintended Pregnancy and Abortion among Unmarried Youth in Vietnam: A Literature Review
Unintended pregnancy and abortion among unmarried youths are public health issues in Vietnam. This review aims to analyse factors influencing unintended pregnancy and abortion among unmarried youths using published and unpublished literatures. An ecological model was used as the conceptual framework with five levels of factors to guide the analysis. The intrapersonal factors include increasing permissive attitudes and practices of premarital sex, lack of knowledge on contraception, and low self-efficacy among females. The interpersonal factors include poor communication among partners and between parents and youths on sexuality-related issues, and peer-influence. The organizational factors include inadequate sexuality education and sexual and reproductive health (SRH) services for youths. The contextual factors include gender inequality, cultural norms, and migration. The final level is lack of separate policy on youth SRH. The findings point out four major determinants of unintended pregnancy and abortion among unmarried youths, including: 1) cultural norms, which consider premarital sex is a taboo; 2) lack and inadequate quality of sexuality education in the schools; 3) lack of youth-friendly SRH services; and 4) no separate policy addressing youth SRH.
Barriers to Implement the National Guidelines on Newborn Care in a Rural Mountainous Province of Vietnam
Reducing the disparity in neonatal health among regions to ensure every mother and her newborn receive the health care they need is a priority in Vietnam. This study was conducted to assess the barriers in implementing the National guidelines on newborn care in a rural mountainous province of Vietnam. Qualitative methods were applied with 28 in-depth interviews and 4 focus group discussions in Daknong province. The results showed that there exist many barriers in implementing the national guideline in newborn care services. There is a big gap between health policy development and policy implementation. The Vietnam government had approved a good strategy and guidelines. Efforts now need to focus on implementing the national guideline and improving quality of care.
Sex Ratio at Birth and the Ideal Family in Chi Linh District, Vietnam
Chi Linh district, which locates in the Red Delta River region, has been recognized as the “hot pot” of high sex ratio at birth in Vietnam. This paper used community-based periodic Demographic-Epidemiologic Surveillance System (CHILILAB) to describe sex ratio at birth (SRB) and identify social - economic factors that related to the SRB. A total 5,940 births born from August 1, 2004 to August 31, 2011 was included in analysis. The SRB of 116.6 boys/100 girls (CI: 110.7 – 122.5) was significantly higher than normal. SRB were found high among second child having only older sister(s), among third child and higher birth order, among mothers who were 35 years and older, running small business or homemakers. Interestingly, a SRB of 91.4 boys/100 girls (CI: 81.8 – 102) was found among second children having an older brother, this is significantly lower than the normal level. Further research should be done to assert if abortion is practiced both to have a son and to have a daughter.
Recent Trends in Gender Ratio at Birth in Hangzhou, China
Introduction: Higher than normal sex ratios at birth in China have been reported since the early 1980’s. This study aimed to investigate recent trends in sex ratio at birth in Hangzhou, capital of Zhejiang Province in southeast China. Methods: Information on selected maternal and birth-related characteristics was extracted from the Hangzhou Birth Information Database for all pregnant women who delivered live births during 2005–2014. The sex ratios at birth were calculated after excluding infants with missing data on gender and those born with ambiguous genitalia. Results: A total of 478,192 male births and 430,852 female births were recorded giving an overall ratio of 111.0. The sex ratio at birth was almost constant at around 110.7 during the period 2005–2008, followed by an increase to the peak at 113.1 in 2010 and then declined back to 109.6 in 2014. Conclusion: The gender ratio at birth in Hangzhou remained unbalanced for the past decade.
Utilization of Health Care Services among Internal Migrants in Hanoi and Its Correlation with Health Insurance: A Cross-Sectional Study
Background: Economic transition (Doi Moi) in the 1980s in Viet Nam has led to internal migration, particularly rural-to-urban migration. Many studies suggested that there is a difference between non-migrants and migrants in using health care services. Current studies have mostly focused on migrants working in industrial zones (IZs) but migrants working in private small enterprises (PSEs) and seasonal migrants seem to be ignored. However, these two groups of migrants are more vulnerable in health care access than others because they usually work without labor contracts and have no health insurance. The study aims to compare the utilization of health care services and explore its correlated factors among these three groups. Methods: This cross-sectional study included 1800 non-migrants and migrants aged 18-55 who were selected through stratified sampling in Long Bien and Ba Dinh districts, Hanoi. These study sites consist of large industrial zones and many slums where most seasonal migrants live in. A structured questionnaire was used to collect information on health service utilization in the last 6 months before the study. Utilization of heath care services was identified as “an ill person who goes to health care centers to seek any treatment (i.e. both private and public health care centers)”. Results: 644 of 1800 participants reported having a health problem in the last 6 months before the study. Among these 644 people, 335 people used health care services. The percentage of non-migrants using health care service was the highest (67.6%), followed by migrants working in IZ (53.7%), migrants working in PSE (44%), and seasonal migrants (42%). Multivariate logistic regression showed migrants, especially seasonal migrants and migrants working in PSE, were less likely to use health care services (OR=0.35, p=0.016 and 0.38, p= 0.004, respectively), compared to non-migrants. The study also found that having no health insurance was a risk factor of the utilization (OR=0.29, p<0.001). Other factors such as gender, age, marital status, socioeconomic status, and monthly income were not related to the utilization of health care services. Conclusion: Seasonal migrants have the worst utilization of health care services, followed by migrants working in PSE, migrants working in IZ, and non-migrants. Health insurance is an important factor relating to the utilization. Accordingly, health insurance coverage needs to be increased if utilization of health care services for the whole population, particularly migrant population, is to be improved.
Cultural context and attitudes towards and practices of condom use: Findings from a study among Vietnamese Injecting Drug Users in Australia
Evidence suggests that culture influences health beliefs and behavior, including risk-taking behaviors. This study explores sexual attitudes and practices pertaining to condom use among a group of ethnic-Vietnamese injecting drug users (IDUs) in Australia. Ethnographic fieldwork and in-depth interviews (n=58) were conducted in South Western Sydney. Interviews were electronically recorded and transcribed verbatim. Open coding was used to classify data into themes, and data were examined for regularities and variations in relationships between and within themes. Results illustrated the relationships between traditional Vietnamese cultural beliefs (mainly rooted in the Triple Teachings of Confucianism, Buddhism, and Taoism) and participants’ beliefs and attitudes toward sexual relationships. The infrequent use of condoms with regular sexual partners and frequent use of condoms with casual partners were embedded in cultural factors such as trust and obligation, stoicism and self-control, belief in fate, and the desire for balance and harmony in body and in mind. These findings highlight the need to understand the cultural contexts of risk for sexual transmission of HIV, particularly in relation to condom use, in order to design and implement culturally appropriate and effective prevention interventions.
Developing a Program Logic for Neonatal Incubator Use in Vietnam
Vietnam has made progress in reducing under-five mortality rate and is on track to meet its fourth Millennium Development Goals. However, the rate of neonatal deaths remains unacceptably high. A critical driver of neonatal mortality is premature birth. In high-income economies, neonatal incubators are a key element of premature newborn care; however, there is limited evidence supporting their use in resource-poor settings. Evaluation is a key process in maximizing the strategic allocation of resources in such settings and one way to construct an evidence base. This research develops a program logic to guide program implementation and an evaluation of incubator use in Vietnam. Key features of program delivery include incorporating community-accepted design elements, facilitating staff training and incubator maintenance needs.
Bypassing Primary Care in Sri Lanka: A Comparative Study on Reasons and Satisfaction
The absence of well demarcated draining areas and lack of clear referral policies have allowed patients in rural Sri Lanka to bypass primary care facilities. This study explored the reasons for bypassing and patient satisfaction of bypassed versus others patients. This was a cross sectional study in a referral and two miner hospitals using an interviewer administered questionnaire. Patients bypassed were mostly married, permanently employed and had a higher monthly income. The most common reason for bypassing was perception of availability of better facilities in the major hospital. Patients by-passed were significantly more satisfied with the cleanliness, seating arrangements and availability of medicine. Patients who did not bypass were significantly more satisfied on accessibility, kindness of health workers and information received. Patients with better social support and stable income tend to bypass the closest facility more often. Improvement of basic facilities at miner hospital and referral policies could reverse the bypassing phenomenon.
Barriers to The Rabies Prevention Program in Phu Tho Province
Background: In recent years, Vietnam has experienced an increasing number of rabies cases. Phu Tho province was one of among the highest incidence, and number of fatalities caused by rabies, in the country. This paper will present barriers in the program of rabies prevention (RP) in Phu Tho province. Methods: The study employed a qualitative design, and data collection was conducted using semi-structured in-depth interviewing technique. 17 health workers, veterinarian staff and locals were purposively selected. Results: Barriers from the local community were the limited rabies prevention practices of the locals. These include delivering the pets to inoculation against rabies, registering the pets and informing responsible agencies about suspected cases. Barriers from the program were limited vaccination for the pets and communication about rabies and a lack of guidance and inter-agency coordination on rabies prevention. Recommendations: More funding for the RP program should be provided, especially for rabies vaccination for pets; communication about rabies prevention should be promoted; and better coordination among agencies is urgently needed.
Prevalence and Risks of Fascioliasis among Adult Cohorts in Binh Dinh and Quang Ngai Provinces-Central Viet Nam
Fascioliasis (liver fluke disease) has raised significant public health concerns in the 15 regional provinces of Central Vietnam, accounting for 93% of the national incidence of the disease. No control measures to date have proven effective. Annual reports show increasing incidence of fascioliasis but they are incomplete. This cross-sectional study was conducted to identify the prevalence of fascioliasis and to describe its associated risks in three communes in Central Vietnam. 500 human blood samples were examined (ELISA); and a survey of knowledge, attitude and practice (KAP) was conducted for 600 randomly selected adults per commune. The findings suggest that overall seroprevalence was 7.75% (95% CI 6.54-9.16%). Among the infected cases, people aged from 18-59 years (85.6%) and farmers (68.0%) accounted for majority of infection. Less than half of participants in all three communes (24.6% - 46.0%) knew the causes of fascioliasis; and considerable proportions ate improperly boiled vegetables (28.2-33.8%), drank unboiled water (23.5-42.5%), and did not own a household toilet (14.2-20.5%). Relatively high prevalence and risks of fascioliasis were found in Central Vietnam, supporting the need for comprehensive intervention measures including selective treatment, health education, and multisectoral approaches to reduce the morbidity associated with fascioliasis and thus improve the health status of the people.
Knowledge about HIV/AIDS, Among Health Workers in Three Provinces in Northern Vietnam: A Cross-Sectional Study
An effective response to HIV requires a strong and sustainable health system with a well-trained workforce. This study aims to explore the knowledge about HIV/AIDS among health workers in three provinces in Northern Vietnam. A cross-sectional study was conducted with 610 health workers. Face-to-face interviews with structured questionnaire on knowledge about HIV/AIDS and self-administered questionnaires on drug use, stigma and discrimination, were conducted. Data were entered using ACCESS, and transferred into STATA 10.0 for analysis. The health workers showed strengths in some domains of knowledge but were weak in others. Knowledge about HIV/AIDS epidemiology, prevention and treatment appeared to be sufficient. In contrast though, only 8% of participants have correct knowledge on positive confirmatory tests, role of voluntary counselling and testing (mean=1.48, range=0-2). Another area of deficiency was knowledge about palliative care and nutrition for people living with HIV (PLHIV). Knowledge levels were low in regards to identifying pain level (12 %), starting time for palliative care (8%), and types of palliative care (mean=0.84, range=0-2). In regards to nutrition, though participants know about food groups needed for the patients (mean=2.23, range=1-3), but only 20% understand that increased nutrition is necessary. The participants demonstrated a comparatively good understanding of negative effects of stigma and discrimination on PLHIV (mean=3.16, range=3-4), their families (mean=2.90, range=2-4), and community (mean=2.32, range=2-3). Despite this, knowledge about concepts of stigma (19 %) and discrimination (13%) remained modest. The multivariable linear regression analysis shows that health workers, who do not support the isolation and separation of PLHIV, and who have positive attitude to PLHIV, have better knowledge about stigma and discrimination. This study demonstrates that besides basic knowledge about HIV/AIDS, priorities should be given to training for health workers on stigma and discrimination reduction as well as on palliative care and nutrition for PLHIV.
Stigma Experiences among People with Schizophrenia in Central Vietnam
Introduction: This study assesses experiences of stigma and its impact upon people with schizophrenia in central Vietnam, as well as examining socio-demographic and clinical predictors. Methods: The study was carried out in Hue city, Vietnam. 246 outpatients with schizophrenia (aged 21-65 years) were interviewed. Consumer Experiences of Stigma Questionnaire (CESQ) and The Stigma Impact Scale were used to evaluate stigma experiences and stigma impact. Results: The most common stigma-related experiences were being treated as less competent (63%), being viewed unfavourably (58%), unwilling concealing of mental condition (58%), and being avoided by others (53%). The highest impact of stigma was described by respondents on their access to employment and education. The degrees of stigma experience and stigma impact were found to be inversely proportional with family income and probability of recovery from schizophrenia. Conclusion: In this population, stigma experience is common and its impact is substantial.
Prevalence of Dementia among the Elderly and Health Care Needs for People Living With Dementia in an Urban Community of Central Vietnam
Introduction: Dementia is one of the major causes of disability and dependency among older people. There is little research on the prevalence of dementia, its related factors and health care needs for people living with dementia in Vietnam. Aims: The aims of this study are: (i) to examine the prevalence of dementia, its related factors among people aged 65 years and above in Hue City of Vietnam, (ii) examine the needs of health care for dementia patients. Methods: 905 people aged 65 years and above living in Hue City in central Vietnam were interviewed and examined. MMSE test (Mini Mental State Examination) was used as a screening instrument for dementia. Diagnosis of dementia was undertaken using ICD-10 research criteria. Results: Overall prevalence estimates for dementia was 9.4%. Age, medical history of stroke, physical activities and entertaining activities were significantly associated with dementia. The most common health care needs for people living with dementia were medication (76.5%), receiving consultation regarding how to care for people with dementia (75.3%), having support and professional advice on how to deal with mental and behavioral disorders (63.5%). Conclusion: In this population, probable dementia is common. Comprehensive care delivery for people living with dementia is urgently needed in Vietnam.